子宫内膜透明细胞癌24例临床分析

目的:探讨子宫内膜透明细胞癌的临床特点及治疗方法。方法:回顾性分析24例子宫内膜透明细胞癌患者的临床表现、病理特征和治疗结果。结果:24例患者确诊为子宫内膜透明细胞癌时的平均年龄57.5岁。术前诊刮的准确率为62.5%。单独化疗12例,放疗2例,孕激素治疗1例,放疗联合化疗7例,放疗或化疗联合孕激素治疗各1例。行彻底肿瘤切除术患者1例术后死亡,余患者平均随访时间29.3个月无复发。手术未切净的5例患者中1例失访,余复发。结论:子宫内膜透明细胞癌晚期病例多,发病年龄与子宫内膜样癌相仿,诊刮准确率低。治疗宜采取全面的手术病理分期、以铂类为主的化疗及盆腔、阴道放疗,预后恶劣。     

卵巢子宫内膜异位症恶性变25例临床分析

目的 探讨卵巢子宫内膜异位症恶性变的临床表现、病理特征、治疗方法和预后。方法 回顾性分析２５例卵巢子宫内膜异位症恶性变患者和病量资料。结果 卵巢子宫内膜异位症恶性变患者的主要症状为盆腔包块、腹胀、腹痛、异常阴道流血和流液。病理类型为子宫内膜样癌１４例,透明细胞癌２例,腺棘癌２例,浆液性腺癌１例,混合性卵巢上皮性癌６例,镜下均可见良性的异位子宫内膜向恶性移行的证据。临床分期为Ⅰ１４例,Ⅱ期７例,Ⅲ期３例,Ⅳ期１例。治疗方法均采用肿瘤细胞减灭术＋化学治疗。患者５年生存率达７７．７％。结论 卵巢子宫内膜异位症恶性变的确切发生率难以估计,该病的治疗以肿瘤细胞减灭术＋化学治疗为主。     

肾透明细胞癌双侧卵巢转移1例

肾透明细胞癌双侧卵巢转移１例广州军区武汉总医院（４３００７０）王晶，周槐玲患者５３岁，住院号１３１４６６，孕５产３，绝经４年，发现盆腔包块８天，于１９９１年１０月入院。１９８７年因左肾透明细胞癌，行肾癌根治术，该次手术前曾行Ｂ超检查，子宫及附件无异常...     

富颈透明细胞癌

宫颈透明细胞癌是一种分化不好的腺鳞癌,1956年首先由Glucksmann和Cherry描述,发病率占宫颈癌的1.6%。美国文献曾报导为1.3%。1972～1978年6年中纽约医学院妇瘤科收治宫颈癌患者491例,有6例为透明细胞癌占1.2%,另外1例在Bellevue医院治疗。本文复习7例透明细胞癌的资料,年龄在27至51岁,平均年龄36岁,比宫颈鳞癌低。组约医学院例病人均为经产妇,平均4次妊娠,另1例为首次妊娠。5例病人因异常阴道出血诊断为癌,其中3例明显为宫颈癌,2例似为宫颈内膜息肉出血。另     

前庭大腺透明细胞癌1例报告并文献复习北大核心CSCD

前庭大腺透明细胞癌罕见,目前仅国外有1篇报道。2013年3月青岛市胶州中心医院收治了1例前庭大腺透明细胞癌患者。本文对患者临床资料进行分析并结合文献复习,对前庭大腺透明细胞癌的临床特征、诊断和治疗及预后进行探讨。     

1989年5卷4期临床疑难病例讨论

本病诊断:子宫透明细胞癌Ⅱ期。本病是子宫内膜癌的一种极少见类型.它与阴道、宫颈、卵巢的透明细胞癌均属同一来源,是发生在不同部位的同类肿瘤。诊断依据:①患者55岁,绝经后4年,阴道有不规则流血及血水样分泌物、有臭味1年余。②曾因阴道流血去某医院诊查“未发现妇科疾病”,于入院前4个月无意中发现下腹包块,无痛,增长较快。③近1个月来有低热.④查体见下腹部膨隆,可触及新生儿头大实性包块,轻度压痛.妇科检查见阴道左壁中上1/3处有5×5cm 肿物,菜花状,质脆出血.B 超检查提示子宫增大至10×18cm,实性光点反射,其右侧后壁有6×8cm 实质性肿物与子宫相连.⑤阴道肿物取活检,病理诊断为。“透明细胞癌”。此例透明细胞癌的原发部位所以考虑子宫,是因为子宫增大明显,且阴道排液1年余。癌肿侵犯子宫     

子宫颈小细胞癌的临床及病理分析

目的 探讨子宫颈小细胞癌的临床病理特征诊断和治疗。方法 回顾性分析８例子宫颈小细胞癌的临床记录和随访资料。结果 ８例均表现为不同程度的阴道排液增多,病理学特点为大小形态一致的圆形或短梭形小细胞,弥漫性浸润间质,符事宫颈小细胞癌的病理学诊断;２例神经元特异性烯醇化酶免疫组织化学染色阳性,８例中,Ｉｂ期５例,Ⅱｂ期３例,７例接受了广泛子宫切除及盆腔淋巴结清扫描术治疗,１例Ⅱｂ期患者仅接受了放射治疗。２     

原发女性生殖器透明细胞癌45例临床分析

原发女性生殖器透明细胞癌 ( ｐｒｉｍａｒｙｃｌｅａｒｃｅｌｌｃａｒｃｉｎｏ ｍａｏｆｆｅｍａｌｅｇｅｎｉｔａｌｔｒａｃｔ,ＰＣＣＣＯＦＧＴ)是一种较少见的、原发于女性生殖器的特殊类型的腺癌。主要发生在阴道、宫颈、宫体和卵巢部位 ,它们具有不同于其他腺癌的独特的生物学行为 ,预后差 ,容易复发和转移[1～ 7] 。现对我院治疗的45例ＰＣＣＣＯＦＧＴ患者进行回顾性分析。1　资料与方法我院从 196 2年 1月～ 2 0 0 0年 12月共收治了 6 5例ＰＣＣＣＯＦＧＴ患者 ,其中原发阴道透明细胞癌 (ｖａｇｉｎａｌｃｌｅａｒｃｅｌｌｃａｒｃ…     

宫颈管透明细胞癌1例

宫颈管透明细胞癌１例益都中心医院丰建艺，王素珍，刘晓玲患者２８岁，因阴道少量流血１５天，大量流血１天于１９９０年７月２８日入院。患者于１９８９年１０月足月分娩一男婴，妊娠期及分娩过程均顺利，产后９个月未来月经，１９９０年７月１２日无诱因出现阴道少量流...     

宫颈和阴道的透明细胞腺癌

宫颈和阴道的透明细胞腺癌,或称中肾癌,为一种发生于年轻女性下生殖道的罕见腺瘤。Novak认为宫颈表皮样癌从未见于12岁以下者,然而宫颈腺癌却有不少见于更年幼的儿童。Waters曾报告1例七个月的女婴患者。1903年Mayer首次描述宫颈透明细胞癌,认为它发源于子宫导管的残余。本病一直是罕见的,但近年来由于雌激素及合成的非类固醇雌激素,特别是乙烯雌酚应用于高危妊娠治疗后,发病率有所增加。Hameed(1968)复习大量文献后指出,透明细胞腺癌在组织学、年     

A case of clear cell carcinoma arising in extragonadal endometriosis

Abstract. Todd RW, Kehoe S, Gearty J. A case of clear cell carcinoma arising in extragonadal endometriosis.
Malignancy developing in extragonadal endometriosis is rare with the majority of cases being endometrioid adenocarcinomas. We present a 54-year-old woman who developed a clear cell carcinoma in her perineum, 25 years after excision of a perineal endometrioma in an episiotomy scar. Treatment involved radiotherapy and surgery, with a view to preserving vaginal function. Where benign extragonadal endometriosis occurs, the potential for malignant transformation persists even years after primary treatment.     

Stage I carcinoma of the endometrium: A 5-year experience utilizing preoperative cesium

A treatment protocol for the management of stage I endometrial carcinoma utilizing preoperative cesium is evaluated. One hundred and twelve consecutive patients were treated according to this protocol over a 5-year period. Based on this experience and a literature review a new protocol is recommended. The significant changes include primary surgery without preoperative cesium, primary treatment based on grade without regard to uterine size, modified radical hysterectomy for G3 tumors, pelvic radiotherapy for clear cell carcinoma confined to the pelvis regardless of depth of invasion, cytoxan, adriamycin, and cis-platinum for papillary serous tumors, and postoperative vaginal cuff cesium for G2 and G3 tumors not requiring pelvic radiotherapy.     

A case report of multicentric verrucous carcinoma of the female genital tract

BACKGROUND: Verrucous carcinoma is a variant of squamous cell carcinoma with distinct features including slow locally invasive growth and verrucous appearance. Verrucous carcinoma of the vagina is considered an extremely rare lesion because only 17 cases have been reported in the literature. CASE: We report a case of vaginal verrucous carcinoma with a second focus in the cervix. The patient was treated with surgery and adjuvant interferon therapy for local recurrence. Human papillomavirus was detected in both vaginal and cervical tumor tissue by immunohistochemistry. CONCLUSION: Diagnosis of verrucous carcinoma may be difficult, particularly if biopsy specimen involves only the surface epithelium. The role of human papillomavirus as an etiologic agent in verrucous carcinoma is still a matter of discussion. Effective management requires surgical resection. The efficiencies of radiotherapy and interferon therapy are discussed.     

52例原发性阴道癌临床分析

Objective?To investigate the clinical features and prognostic factors of primary vaginal cancer. Methods?A total of 52 patients with complete pathological diagnosis and clinical follow-up data were selected from the first Affiliated Hospital of Zhengzhou University from January 2013 to January 2020. The general characteristics, different treatment methods and overall prognosis of the patients were analyzed. Results?the 1-year, 3-year and 5-year survival rates of 52 patients with primary vaginal cancer were 80.7%, 61.1%, and 48.1%, respectively. Among them, 28 patients (53.8%) had squamous cell carcinoma, and the median survival time was 92 months. There were 12 cases of malignant melanoma (23.0%), and the median survival time was 12 months The 5-year survival rates of early stage (stageⅠ+stageⅡ) and late stage (stageⅢ+stageⅣ) were 61.0% and 0.0%, respectively. Univariate analysis showed that FIGO stage, pathological type, tumor size, treatment mode, tumor growth stage and vaginal invasion length were related to the prognosis of patients (P<0.05). COX multivariate regression analysis showed that 2009 FIGO stage (P=0.002) and pathological type (P=0.000) were independent factors affecting the prognosis of patients with primary vaginal cancer.  The prognosis of different pathological types, such as squamous cell carcinoma and malignant melanoma, was significantly different (χ2=17.704, P=0.000). There was statistically significant difference between combined radiotherapy and chemotherapy with radiotherapy or chemotherapy alone (χ2= 4.017, P=0.045). Conclusion?The prognosis of primary vaginal cancer is related to pathological type and clinical stage. The earlier the clinical stage, the better the prognosis. The survival cycle of squamous cell carcinoma is much higher than that of malignant melanoma. The treatment is mainly radiotherapy, and the combined treatment of radiotherapy and chemotherapy is better than radiotherapy or chemotherapy alon.     

Vaginal metastasis and thrombocytopenia from renal cell carcinoma

BACKGROUND: Vaginal cancer represents approximately 1-2% of genital tract malignancies. Most cases represent metastasis from the cervix, endometrium, or colon. Metastasis of renal cell carcinoma to the vagina is extremely rare. CASE: A 58-year-old female presented with a bleeding vaginal lesion. Laboratory studies revealed severe thrombocytopenia, and radiological studies revealed a left renal mass; excision was consistent with metastatic renal cell carcinoma. A subsequent nephrectomy confirmed renal cell carcinoma. Postoperatively, the patient underwent immunotherapy and the thrombocytopenia resolved. CONCLUSION: We report the first case of metastatic renal cell carcinoma presenting as a vaginal metastasis with thrombocytopenia as a paraneoplastic manifestation. Renal cell carcinoma must be in the differential diagnosis of a clear cell neoplasm in a postmenopausal woman, particularly with systemic symptoms suggestive of a paraneoplastic syndrome.     

Pelvic exenteration in clear cell adenocarcinoma of the vagina and cervix

Pelvic exenteration was performed in 29 of 527 cases of vaginal and cervical clear cell adenocarcinoma (CCA). Exenteration was the initial therapy in 21 cases (1 stage I, 15 stage II, 3 stage III, 1 stage IV, and 1 unknown stage) and was undertaken in 8 cases for central failure after primary radiotherapy. Of the 78 patients with stage II vaginal CCA, the 9 treated with primary exenteration were compared with the 69 who had other modalities of therapy; no significant difference in the survival experience was noted between the two groups. Among the 96 patients with stage II cervical CCA the survival experience was less favorable for those who underwent primary exenteration (n = 5) than for those who were treated with other varieties of therapy (n = 91). Of the 34 patients with central treatment failure, 8 had exenteration and 26 had other forms of therapy. The overall 5- and 8-year actuarial survival rates for the exenteration group (100 and 60%) do not differ significantly from those for the nonexenteration group (71 and 56%). Primary exenteration was used more frequently in the 1970s but has been predominantly reserved for the treatment of recurrent disease during the past decade. Survival statistics after exenteration for central failure are more favorable in cases of vaginal and cervical CCA than in cases of cervical squamous carcinoma.     

Tumor cell spillage to the vaginal cavity and vaginal stump during the surgery of endometrial carcinoma

BACKGROUND: Our purpose was to investigate the spillage of the endometrial carcinoma cells to the vaginal cavity and vaginal stump during the surgery. METHODS: Cytologic examination of specimens obtained from the vaginal cavity and vaginal stump during surgery performed on 15 patients with endometrial carcinoma. And the risk factors of carcinoma cell spillage to the vaginal cavity were investigated. RESULTS: Carcinoma cells from the vaginal cavity were negative for nine patients and positive for six patients. Those from the vaginal stump were negative for l4 patients and positive for one patient. In one patient, both were positive. Total abdominal hysterectomy might be one risk of carcinoma cell spillage to the vaginal cavity compared with modified radical hysterectomy and radical hysterectomy. CONCLUSIONS: Endometrial carcinoma cells were spilled into the vaginal cavity in not a few cases and their spillage from there to the vaginal stump could follow during the surgery.     

子宫颈小细胞癌八例临床病理分析

目的 研究宫颈小细胞癌的临床病理特征、治疗方法和预后.方法 回顾性分析1999年1月至2005年12月间中国医学科学院中国协和医科大学肿瘤医院妇瘤科收治的8例宫颈小细胞癌患者的临床及病理资料.结果 8例患者均表现为不规则阴道流血或接触性出血.临床分期按1994年国际妇产科联盟分期标准为Ⅰ b1期1例、Ⅰ b2期2例、Ⅱ b期2例、Ⅲb期3例.组织学特点为体积小的圆形或短梭形细胞,形态大小较一致,细胞质少,核深染,染色质细,核仁不明显,核分裂象多见.7例行免疫组化染色,神经元特异性烯醇化酶均为阳性.3例Ⅰ b期和1例Ⅲb期患者行手术治疗,术后辅助化疗(或加放疗),生存时间分别为64、22、14和6个月.2例Ⅱ b期和2例Ⅲb期患者行放、化疗,生存时间分别为25、9、10和5个月.结论 联合光镜和免疫组化法检查可提高宫颈小细胞癌诊断的准确率.治疗应采用综合治疗,尤其应重视化疗的作用.     

Prognostic factors in FIGO stage IB cervical cancer without lymph node metastasis and the role of adjuvant radiotherapy after radical hysterectomy

OBJECTIVES: The aim of this study was to evaluate the clinical and pathologic prognostic variables for disease free survival, overall survival and the role of adjuvant radiotherapy in FIGO stage IB cervical carcinoma without lymph node metastasis. METHODS: A retrospective review was performed of 393 patients with lymph node negative stage IB cervical cancer treated by type 3 hysterectomy and pelvic lymphadenectomy at the Hacettepe University Hospitals between 1980 and 1997. RESULTS: The disease free survival and overall survival were 87.6 and 91.0%, respectively. In univariate analysis, tumor size, depth of invasion, vaginal involvement, lympho-vascular space involvement (LVSI) and adjuvant radiotherapy were found significant in disease free survival. Overall survival was affected by tumor size, LVSI, vaginal involvement and adjuvant radiotherapy. Tumor size, LVSI and vaginal involvement were found as independent prognostic factors for overall and disease free survival in multivariate analysis. Disease free survival, recurrence rate and site did not differ between patients underwent radical surgery and radical surgery plus radiotherapy. CONCLUSION: Tumor size, LVSI and vaginal involvement were independent prognostic factors in lymph node negative FIGO stage IB cervical cancer. Adjuvant radiotherapy in stage IB cervical cancer patients with negative nodes provides no survival advantage or better local tumoral control.     

Cervical cancer--a neglected health tragedy.

This is a review of the problems of cervical cancer in Nigeria, typified by data from a tertiary hospital over a 9-year period. Of 146 cases of cervical cancer studied, 79% presented in advanced stages, peak age incidence was between 40 and 70 years, mean 54.5 +/- 12.4 (SD) years. Squamous cell carcinoma was predominant (97% of cases). Presentation was typical: mainly abnormal vaginal bleeding, vaginal discharge and postmenopausal bleeding. Low socioeconomic status (90%) and high parity (83%) were prominent features. Treatment and outcome were poor because of late presentation, lack of radiotherapy facilities and inadequate surgical procedures. Comparison with previous Nigerian studies reveal a continued lack of improvement over the years as regards preventative strategies and adequate treatment facilities. Suggestions on cervical cancer control measures for developing countries like Nigeria are given.